[cpvc_custom_form_container cpvc_select_campaign=”3″ cpvc_form_style=”style_2″ cpvc_input_text_color=”#ffffff” cpvc_input_border_color=”#3a6465″ cpvc_input_font_size=”18″ cpvc_input_vertical_pedding=”12″ cpvc_label_visibility=””]
[/cpvc_custom_form_container]
[cpvc_textfield field_label=”First Name” field_name=”firstname” placeholder=”* First Name” required_field=”1″ cpvc_css=”.vc_custom_1562603072701{margin-right: 300px !important;}”][cpvc_emailfield field_label=”eMail” placeholder=”* eMail” required_field=”1″]
[cpvc_textfield field_label=”Last Name” field_name=”lastname” placeholder=”* Last Name” required_field=”1″ cpvc_css=”.vc_custom_1562603079598{margin-right: 300px !important;}”][cpvc_textfield field_label=”eMail” field_name=”email” placeholder=”* eMail” required_field=”1″ cpvc_css=”.vc_custom_1562636422307{margin-right: 300px !important;}”]
company details (optional)
[cpvc_textfield field_label=”Your Company” field_name=”company” placeholder=”Your Company” required_field=””][cpvc_textfield field_label=”Title” field_name=”title” placeholder=”Title” required_field=””][cpvc_textfield field_label=”Website” field_name=”website” placeholder=”Website” required_field=””][cpvc_textfield field_label=”Street Address” field_name=”address” placeholder=”Street Address” required_field=””]
[cpvc_textfield field_label=”City” field_name=”city” placeholder=”* City” required_field=”1″ cpvc_css=”.vc_custom_1562635163351{margin-right: 300px !important;}”]
[cpvc_textfield field_label=”State / Region” field_name=”state” placeholder=”* State / Region” required_field=”1″ cpvc_css=”.vc_custom_1562635191669{margin-right: 300px !important;}”]
[cpvc_textfield field_label=”Country” field_name=”country” placeholder=”* Country” required_field=”1″ cpvc_css=”.vc_custom_1562635398221{margin-right: 300px !important;}”]
[cpvc_submit_button cpvc_button_text=”REGISTER” cpvc_btn_text_hover_color=”#6ec3c7″ cpvc_btn_bg_color=”#448192″ cpvc_css=”.vc_custom_1562636543764{margin-top: 25px !important;margin-bottom: 25px !important;}”]
